Severe Lactic Acidosis, which is most effective dialysis modality that you use to try and correct this type of acidemia?
Do you fine that different cause's of lactic acidemia (Hypoxic and non-hypoxic) respond more effectively to a specific type of dialysis modality, i.e. Metformin to CVVHDF or CVVHD etc?
Also, Citrate is steadily overtaking the role of Heparin and other anticoagulants in the anticoagulation role to keep dialysis machines running longer without hindrance.
Do users find citrate more effective in clearing acidemia with dialysis than using other anticoagulants or none at all depending on the patients APTT and ratios?
Do you know of any research papers that have studied this particular topic?
Hi Jeremy
I hope that following attached paper and link will help you.
Best Regards
http://patient.info/doctor/lactic-acidosis
Dear Sir,
Thank you for your kind response.
I will look at these items with interest.
Best wishes
Jeremy
Citrate anticoagulation during hemodialysis is preferable to low dose heparin anticoagulation if there is a high risk of bleeding. However, in severe lactic acidosis there is no advantage of citrate vs. heparin anticoagulation. If the patient is in shock a continuous procedure may be indicated in lactic acidosis with heparin anticoagulation.
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